872: Age-specific anti-mullerian hormone (AMH) and preeclampsia: a 15-year cohort study

Abstract

To investigate if there is any association between ovarian reserve status and preeclampsia. This longitudinal study was conducted on participants of Tehran Lipid and Glucose Study, an ongoing population based cohort study with 15 years follow up. Ovarian reserve status was identified according to age specific AMH levels, calculated using the exponential–normal 3-parameter model. Comparisons between those with and without preeclampsia were made using appropriate statistical methods. The association between age specific AMH and Preeclampsia was evaluated based on Buckley James regression method. 781 women, aged 20 -50 years, met eligibility criteria: 80 and 701 with and without confirmed preeclampsia, respectively. Prevalence of preeclampsia were 23 (11.1%), 12 (6.4 %), 26 (13.3%) and 19 (10%) in 1st, 2nd, 3rd and 4th quartiles of age specific AMH, respectively (P = 0.16). The median and inter quartile range of serum AMH level was 1.05 (0.36 – 2.2) mg/L in women with a history of preeclampsia compared with 0.85 (0.28 – 2.1) mg/L in women with normotensive pregnancies. Based on Buckley James regression method, decrease in AMH levels, with increasing age and BMI, was not statistically different in PE compared with that for women with normotensive pregnancies. Logistic regression analysis, with having variables age-specific AMH quartile, smoking status, BMI and systolic blood pressure in the model, revealed no association between preeclampsia and age-specific AMH quartiles. Also ROC analysis on age-specific AMH showed no predictive performance for preeclampsia; area under curve (95% CI) was 0.54 (0.45 – 0.63) (P = 0.40). Although the exact pathophysiology of AMH in ovarian aging is still a matter of debate, it is well documented that AMH is an appropriate biomarker of ovarian reserve and function and ovarian insufficiency is associated with vascular risks and events. Our study showed that age-specific AMH may not be valuable in predicting incidence of preeclampsia. Future cohort studies with multiple AMH measurements and bench research to investigate the pathophysiology are needed.View Large Image Figure ViewerDownload Hi-res image Download (PPT)